Noppanun Nankongnab

Organophosphate Urinary Metabolite Levels during Pregnancy, Delivery and Postpartum in Women Living in Agricultural Areas in Thailand

Organophosphate Urinary Metabolite Levels during Pregnancy, Delivery and Postpartum in Women Living in Agricultural Areas in Thailand: Pornpimol KONGTIP, et al. Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Thailand—

Glyphosate and Paraquat in Maternal and Fetal Serums in Thai Women

ABSTRACT Objectives: This longitudinal study measured the glyphosate and paraquat concentrations found in maternal and umbilical cord serum in 82 pregnant women who gave birth in three provinces of Thailand. Methods: Through questionnaires and biological samples collected at childbirth, factors such as personal characteristics, family members occupation, agricultural activities, and herbicide use in agricultural work were evaluated as predictors of glyphosate and paraquat levels in the pregnant women. Statistical analysis used univariate and binary multiple logistic regression, where the outcome was the probability of exposure to paraquat or glyphosate above the limit of detection associated with occupation and household factors. Results: The glyphosate concentrations in the pregnant women’s serum at childbirth (median: 17.5, range: 0.2–189.1 ng/mL) were significantly higher (P < .007) than those in the umbilical cord serum (median: 0.2, range: 0.2–94.9 ng/mL). However, the paraquat concentrations in the serum of the pregnant women at childbirth (83% ≤limit of detection [LOD], with maximum of 58.3 ng/mL) were similar to those in the umbilical cord serum (80% LOD in serum at childbirth were 11.9 times more likely to report work as an agriculturist (P < .001), 3.7 times more likely to live near agricultural areas (P = .006), and 5.9 times more likely to have a family member who worked in agriculture (P < .001). The only factors affecting paraquat exposures in pregnant women at childbirth were reporting the agricultural activity of digging in farm soil and working in the agricultural fields in the third trimester of pregnancy. Conclusions: These results show that pregnant women who work in agriculture or live in families that work in agriculture have higher exposures to the herbicides glyphosate and paraquat. The potential for long-term health impacts of these prenatal exposures to children should be evaluated, and greater regulation of the sale and use of herbicides should be considered in Thailand.

The Impact of Prenatal Organophosphate Pesticide Exposures on Thai Infant Neurodevelopment

A birth cohort was begun to investigate the levels and sources of pesticide exposure in pregnant women living in Thailand, and to examine the effects of pesticide exposure on infant neurodevelopment at five months of age. Subjects were interviewed using questionnaires regarding their demographic characteristics, educational background, and work and home activities related to pesticide exposures. Spot urine samples were collected at 28 weeks gestation and analyzed by gas chromatography-mass spectrometry to determine maternal metabolite levels of organophosphate pesticides including dimethyl phosphate (DMP); total DEP (diethyl phosphate (DEP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP), and total DAP (the sum of all metabolite levels). At five months of age, infant development was evaluated using the Bayley Scales of Infant and Toddler Development-III (Bayley-III). Higher total DEP and total DAP metabolite levels from the mother at 28 weeks’ gestation were significantly associated with reduced motor composite scores on the Bayley-III at five months of age. The total DEP levels were also significantly associated with reduced cognitive composite scores. Prenatal concentrations of maternal urinary metabolites were associated with infant cognitive and motor development. The results of several studies now suggest the need for public health intervention to reduce prenatal pesticide exposures from both agricultural and domestic use.

Occupational Safety, Health, and Well-being Among Home-based Workers in the Informal Economy of Thailand

The objective of this article is to provide a summary of the issues related to occupational safety and health and well-being among workers in the informal economy of Thailand, with a special emphasis on home-based workers. The reviewed literature includes documents and information sources developed by the International Labour Organization, the National Statistical Office of Thailand, peer-reviewed scientific publications, and master’s theses conducted in Thailand. This work is part of a needs and opportunities analysis carried out by the Center for Work, Environment, Nutrition and Development—a partnership between Mahidol University and University of Massachusetts Lowell to identify the gaps in knowledge and research to support government policy development in the area of occupational and environmental health for workers in the informal economy.

835 Occupational health and safety management in thai hospital

Introduction Statistic showed that hospital is the most hazardous workplace. More than 3 00 000 healthcare workers were employed in approximately 2627 public and 321 private hospitals in Thailand. Methods The cross-sectional study aimed to investigate the occupational health and safety management in five Thai hospitals. The questionnaire consisted of characteristic of healthcare workers both working directly with patient such as inpatient, out- patient and not working directly with patients such as nutrition service and hospital supporting service departments, accident statistics and occupational health and safety management. Results The result showed that healthcare workers in inpatient department had highest percentage reporting all 29 items of occupational health and safety management such as having safety policy, communication of policy to staff, having safety committee meeting, alarm system preparedness, fire prevention and protection preparedness, personal protective equipment provided, etc. followed by out-patient, nutrition service and hospital supporting service departments. The accident in the past three months indicated that the accident of sharp injury and falling from slippery floor in the nutrition service were 57.7% and 26.9%, respectively. Furthermore, the comparison of the accident of sharp injury and falling from slippery floor of nutrition service with other departments was statistically significant different (p<0.001). The accident of needle stick and contact with chemicals, body fluid in surgery and anaesthesia department were 26.9% and 11.5%, respectively. The comparison of needle stick and contact with chemicals, body fluid of surgery and anaesthesia department with other departments was statistically significant different that were p<0.001 and p=0.024, respectively. Conclusion The situations of occupational health and safety management in Thai hospital were crucial for problem recognition and making the further control measure

Paraquat Exposure of Pregnant Women and Neonates in Agricultural Areas in Thailand

This study aimed to assess paraquat concentrations in the urine of women at 28 weeks of pregnancy, delivery and 2 months postpartum and in the meconium of neonates. In all, 79 pregnant women were recruited from three hospitals located in agricultural areas in Thailand. The subjects were interviewed about personal characteristics, agricultural activities and pesticide use patterns. Paraquat was analyzed in urine and meconium using high performance liquid chromatography equipped with a fluorescence detector. The geometric mean (GSD) of urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum were 2.04 (4.22), 2.06 (5.04) and 2.42 (5.33) ng/mL, respectively. The urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum between agriculturist and non-agriculturist were not significantly different (p = 0.632, p = 0.915, p = 0.57, respectively). The geometric mean (GSD) of paraquat concentration in the meconium was 33.31 (4.59) ng/g. The factors predicting paraquat exposures among pregnant women and neonates included working outside, living near farmland, having family members who work on a farm, drinking well water and using herbicides or paraquat.

Differences among Thai Agricultural Workers’ Health, Working Conditions, and Pesticide Use by Farm Type

More than 11 million Thai people (38%) work in agriculture, but since most are in the informal sector, government enforcement and support are very limited. As a result, working conditions on Thai farms vary greatly, putting the health of many agricultural workers at risk. A cross-sectional study in three Thai provinces collected information on the work activities and conditions of 424 farmers representing five farm types: rice, vegetable, flower, rice/vegetable, and flower/vegetable. The agricultural workers were mainly women (60%); their average age was 53 but ranged from 18 to 87 years. More than 64% worked more than 5 days/week. Seventy-four percent of them had only primary school education. A number of the health and hazardous working conditions surveyed were significantly different by farm type. Rice farmers were found to have the highest prevalence of allergies, nasal congestion, wheezing, and acute symptoms after pesticide use, while flower farmers had the lowest prevalence of these health outcomes. Rice farmers reported the highest prevalence of hazardous working conditions including high noise levels, working on slippery surfaces, sitting or standing on a vibrating machine, spills of chemicals/pesticides, and sharp injuries. The lowest prevalence of these working conditions (except noise) was reported by flower farmers. Vegetable farmers reported the highest prevalence knee problems, while rice farmers had the lowest prevalence. Among these farmers, more than 27 different types of pesticides were reported in use during the past year, with the majority reporting use once a month. The flower/vegetable farming group reported the highest frequency of good exposure prevention practices during pesticide use. They were the most likely to report using cotton or rubber gloves or a disposable paper masks during insecticide spraying. Those farmers who only grew vegetables had the lowest frequency of good exposure prevention practices, including use of personal protective equipment. The economic cost of work-related injuries and illnesses among informal sector agricultural workers in Thailand is unknown and in need of study. Gaps in the regulations covering pesticide sales allow farmers to purchase pesticides without adequate training in their safe use. Training targeted to farm type regarding safe pesticide use and the prevention of accidents and musculoskeletal disorders is needed. Studies of chronic health effects among Thai farmers are needed, with special emphasis on respiratory, metabolic disease and cancer.

A pilot study of maternal exposure to organophosphate pesticides and newborn neurodevelopment in Thailand

Abstract The objective of this study was to evaluate whether prenatal exposures to organophosphate (OP) pesticides from maternal agricultural use are associated with neonatal neurobehavioral effects. A pilot study conducted in three provinces in Thailand measured maternal urinary metabolites of OP pesticides in pregnant women at 7 months gestation and at birth. Within 3 days of birth, 82 newborns underwent neurobehavioral testing using the Brazelton Neonatal Behavioral Assessment Scale (NBAS). Comparison of the NBAS test results with maternal OP metabolite levels found the neonates NBAS Habituation cluster score increased with maternal dimethylphosphate (DMP) levels (p = 0.04) while the Range of State score increased with total diethylphosphate (DEP) levels (p = 0.01). The Number of Abnormal Reflexes in the neonate also increased as maternal urinary total DEP levels increased (p = 0.06). These preliminary findings suggest that pre-natal exposures to OP pesticides can impact newborn neurodevelopment and support the need for a longitudinal evaluation of childhood neurodevelopment in relation to pesticide exposures in Thailand.

P339 Results from a survey of the working conditions of stone sculptors in nakhon ratchasima province, thailand

This project was a cross-sectional survey of the working environment and health outcomes of 102 Thai stone sculptors in northeast Thailand. In addition, postural analysis was conducted on 25 stone sculptors using the REBA method. Most stone sculptors were male (90%), had worked an average of 9.6 years, worked 6 days/week, an average of 6.9 hours. About 67% reported being exposed to high levels of noise and 10% reported reduced hearing. Postural analysis by REBA found that 80% were in a MSD high risk category. Reports of musculoskeletal disorders in the past 3 months were common with symptoms reported by 28% for the lower back and 17% for the upper back. Moreover, 12% of the stone sculptors reported an abnormal chest x-ray, 5% had silicosis and over 29% reported cough or cough with phlegm. The stone sculptors also reported that in the past 3 months 64% had an accident with the tools used on the job (power drills, grinders, saws and hand tools), 20% reported sharp injuries and 7% electric shocks. Although most workers (93%) knew that silica dust could cause silicosis, use of controls was limited. Although 87% reported wearing a mask regularly, only 60% reported having an N95 respirator. Only 46% reported wearing eye protection regularly, only 27% reported using hearing protection regularly and only 17% used safety shoes. Therefore, an important initial step is further education and provision of adequate PPE at lower prices. In addition, introduction of engineering controls would help eliminate silica, ergonomic and safety hazards at the source.

P282 Impact of prenatal organophosphate pesticide exposure on infant neurodevelopment in thailand

A longitudinal birth cohort was begun to investigate the levels and sources of pesticide exposure during pregnancy and to examine the effects of pesticide exposure on infant neurodevelopment at 5 months of age. Subjects were interviewed using questionnaires regarding their demographic characteristics, educational background, family composition, work and pesticide exposure. Also, spot urine samples were collected at 28 weeks gestation to determine maternal dimethyl phosphate (DMP), diethyl phosphate (DEP), diethyl thiophosphate (DETP), diethyl dithiophosphate (DEDTP), and total dialkyl phosphate (DAP) levels by gas chromatography-mass spectrometry. At 5 months of age, infant development was evaluated using the Bayley Scale of Infant and Toddler Development – III. Measurable levels of metabolites of organophosphate pesticides were found in urine samples from Thai women at 28 weeks of pregnancy. The primary factors that had significant influences on maternal urinary DAP concentrations were outdoor employment, farm worker jobs involving digging in the soil and applying pesticides. Prenatal organophosphate pesticide exposure, specifically maternal urinary DEDTP concentration, was significantly associated with infant cognitive, fine motor, fine and gross motor Bayley test scores (p < 0.05).